2项指标联合检测在慢性心力衰竭诊断中的应用价值
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摘要
目的探讨心型脂肪酸结合蛋白和同型半胱氨酸联合检测在慢性心力衰竭诊断中的应用价值,并结合相关临床表现,为临床诊治提供依据。方法选择2013年2月至2014年4月确诊为慢性心力衰竭的患者68例作为试验组,同期健康体检人员70例作为对照组,并对心型脂肪酸结合蛋白、同型半胱氨酸水平进行检测。结果与对照组比较,试验组患者的心型脂肪酸结合蛋白和同型半胱氨酸水平均有明显升高,差异有统计学意义(P<0.05);试验组单独检测心型脂肪酸结合蛋白和同型半胱氨酸的阳性率分别为86.76%、88.24%,均低于联合检测阳性率(94.12%),差异有统计学意义(P<0.05);以临床诊断为金标准,2项指标联合检测结果与临床诊断结果 Kappa一致性分析得出Kappa=0.94。结论心型脂肪酸结合蛋白和同型半胱氨酸对于慢性心力衰竭疾病的辅助诊断具有一定的临床价值,两者联合检测能有效提高阳性检出率,降低漏诊率。
Objective To explore the clinical significance of the heart-type fatty acid-binding protein and homocysteine combined testing to the chronic heart failure diagnosis Methods 68 cases of patients of chronic heart failure were chosed as the study group and 70 cases healthy were checked up as the control group.The levels of hearttype fatty acid-binding protein and homocysteine testing were analyzed.Results Compared with the control group,the levels of heart-type fatty acid-binding protein and homocysteine in the study group were significantly higher than those of the control group(P<0.05).The positive detection rate of the heart-type fatty acid-binding protein and homocysteine in the study group was 86.76% and 88.24%,and the positive detection rate of the two indicators combined testing was 94.12%,which was significantly higher than those of separate testing.Compared with the gold standard of clinical diagnosis,the Kappa was 0.94.Conclusion There is a certain clinical value of the heart-type fatty acid-binding protein and homocysteine to the chronic heart failure diagnosis,and we can effectively improve the positive rate by combined testing,reduce the rate of misdiagnosis.
Objective To explore the clinical significance of the heart-type fatty acid-binding protein and homocysteine combined testing to the chronic heart failure diagnosis Methods 68 cases of patients of chronic heart failure were chosed as the study group and 70 cases healthy were checked up as the control group.The levels of hearttype fatty acid-binding protein and homocysteine testing were analyzed.Results Compared with the control group,the levels of heart-type fatty acid-binding protein and homocysteine in the study group were significantly higher than those of the control group(P<0.05).The positive detection rate of the heart-type fatty acid-binding protein and homocysteine in the study group was 86.76% and 88.24%,and the positive detection rate of the two indicators combined testing was 94.12%,which was significantly higher than those of separate testing.Compared with the gold standard of clinical diagnosis,the Kappa was 0.94.Conclusion There is a certain clinical value of the heart-type fatty acid-binding protein and homocysteine to the chronic heart failure diagnosis,and we can effectively improve the positive rate by combined testing,reduce the rate of misdiagnosis.
引文
[1]李凤云,杨凤兰,张秀萍,等.心型脂肪酸结合蛋白对急性心肌梗死患者心功能的评估价值[J].中国煤炭工业医学杂志,2013,16(10):1612-1614.
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[8]贺婷.老年慢性心力衰竭患者自我护理行为与其生活质量的相关性[J].解放军护理杂志,2013,30(13):22-25.
[9]魏振衡,冉华中.73例老年慢性心力衰竭临床分析[J].中国实用医药,2011,6(27):89-90.
[10]罗珮珏,孙亚军.血清胱抑素C检测评估慢性心力衰竭患者预后的价值[J].现代中西医结合杂志,2011,20(16):2029-2030.
[11]孙裕平,王文棣,马少春,等.慢性心力衰竭患儿心型脂肪酸结合蛋白的变化及临床意义[J].中国当代儿科杂志,2013,15(2):99-101.
[12]刘煌,杨云净,罗艳.慢性心力衰竭患者血清心型脂肪酸结合蛋白水平检测及其临床价值[J].重庆医学,2012,41(21):2184-2185.
[13]李军.同型半胱氨酸水平与慢性心力衰竭的关系[J].同济大学学报:医学版,2012,33(2):117-121.
[14]雷登顺.探讨同型半胱氨酸和高敏C反应蛋白作为慢性心力衰竭危险因子的临床意义[J].中国实验诊断学,2013,17(8):1434-1436.
[2]姚玉婷,倪秀石,戴嘉,等.血清同型半胱氨酸水平与老年慢性心力衰竭患者心脏结构和功能的相关性研究[J].老年医学与保健,2013,9(4):211-213.
[3]焦淑静.慢性心力衰竭患者NT-proBNP和D-D及HCY联检的临床应用[J].中国现代药物应用,2013,7(5):22-24.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095.
[5]杨有业,张秀明.临床检验方法学评价[M].北京:人民卫生出版社,2008:48-51.
[6]赵跃萍,刘爽,张晓启.老年慢性心力衰竭患者复发的影响因素及护理对策[J].武警医学院学报,2011,20(4):315-316.
[7]陈燕,吕蓉,季诗明,等.慢性心力衰竭患者预后影响因素的调查分析[J].中华护理杂志,2012,47(6):528-530.
[8]贺婷.老年慢性心力衰竭患者自我护理行为与其生活质量的相关性[J].解放军护理杂志,2013,30(13):22-25.
[9]魏振衡,冉华中.73例老年慢性心力衰竭临床分析[J].中国实用医药,2011,6(27):89-90.
[10]罗珮珏,孙亚军.血清胱抑素C检测评估慢性心力衰竭患者预后的价值[J].现代中西医结合杂志,2011,20(16):2029-2030.
[11]孙裕平,王文棣,马少春,等.慢性心力衰竭患儿心型脂肪酸结合蛋白的变化及临床意义[J].中国当代儿科杂志,2013,15(2):99-101.
[12]刘煌,杨云净,罗艳.慢性心力衰竭患者血清心型脂肪酸结合蛋白水平检测及其临床价值[J].重庆医学,2012,41(21):2184-2185.
[13]李军.同型半胱氨酸水平与慢性心力衰竭的关系[J].同济大学学报:医学版,2012,33(2):117-121.
[14]雷登顺.探讨同型半胱氨酸和高敏C反应蛋白作为慢性心力衰竭危险因子的临床意义[J].中国实验诊断学,2013,17(8):1434-1436.